Intraluminal tissue modifying systems and associated devices and methods

Abstract

The present technology is directed generally to devices, systems, and methods for capturing and cutting fibrous and trabeculated structures (such as synechiae) in vessel lumens. In one embodiment, the present technology includes an intraluminal tissue modifying system configured to capture the fibrous structures, put the fibrous structures in tension, and controllably cut through the fibrous structures without applying appreciable additional force to the vessel wall. The system may include an expandable capture device and a cutting device.

We claim: 
     
       1. A method for modifying intraluminal tissue, the method comprising:
 intravascularly delivering a distal portion of an elongated shaft to a treatment site within a blood vessel; 
 deploying a capture member at the distal portion such that the capture member bends outwardly away from a longitudinal axis of the elongated shaft and includes (a) a generally curved distal segment extending between a distal joint and an intermediate joint, and (b) a generally curved, concave proximal segment extending between the intermediate joint and a proximal joint; and 
 capturing intraluminal tissue of the blood vessel with the proximal segment of the capture member. 
 
     
     
       2. The method of  claim 1  wherein:
 the capture member is one of a plurality of capture members; 
 the elongated shaft is an outer shaft; and 
 deploying the plurality of capture members comprises moving an inner shaft disposed within the outer shaft in a proximal direction relative to the outer shaft, wherein a distal end region of the inner shaft is fixed to a distal end region of the outer shaft such that proximal movement forces the capture members to bend outwardly. 
 
     
     
       3. The method of  claim 2  wherein the outer shaft includes a plurality of slots extending along a length of the distal portion, and wherein portions of the outer shaft between the slots define the capture members, and wherein moving the inner shaft in the proximal direction pulls distal portions of the capture members proximally to force the capture members to bend outwardly. 
     
     
       4. The method of  claim 1  wherein deploying the capture member causes the capture member to preferentially flex or bend at each of the distal, proximal, and intermediate joints. 
     
     
       5. The method of  claim 1 , further comprising:
 deploying a cutting element from the distal portion of the elongated shaft such that the cutting element extends outwardly away from the central longitudinal axis of the elongated shaft at a location proximate to the proximal segment of the capture member; and 
 cutting the intraluminal tissue with the cutting element. 
 
     
     
       6. The method of  claim 5  wherein deploying the cutting element comprises deploying the cutting element from a position proximal to the proximal segment of the capture member. 
     
     
       7. The method of  claim 5  wherein deploying the cutting element comprises deploying the cutting element from a position distal to the proximal segment of the capture member. 
     
     
       8. The method of  claim 1 , further comprising:
 placing the intraluminal tissue in tension with the proximal segment of the capture member; 
 deploying a cutting element from a position proximal to the proximal segment of the capture member such that the cutting element extends outwardly away from the central longitudinal axis of the elongated shaft and slides distally through an elongated opening in the proximal segment to cut the intraluminal tissue. 
 
     
     
       9. The method of  claim 8  wherein:
 the elongated shaft is an outer shaft; 
 the cutting element is one of multiple cutting elements; 
 deploying the multiple capture members comprises moving an inner shaft disposed within the outer shaft in a proximal direction relative to the outer shaft, wherein a distal end region of the inner shaft is fixed to a distal end region of the outer shaft such that proximal movement forces the capture member to bend outwardly; 
 the method further comprises—
 deploying cutting elements through slots in the outer shaft such that the cutting elements extend outwardly away from the central longitudinal axis of the elongated shaft; and 
 cutting, with at least one of the cutting elements, the intraluminal tissue proximate to at least one of the proximal segments. 
 
 
     
     
       10. The method of  claim 1 , further comprising:
 deploying cutting elements radially outwardly away from the central longitudinal axis of the elongated shaft; and 
 rotating the cutting elements to cut the intraluminal tissue proximate to the proximal segments. 
 
     
     
       11. The method of  claim 1 , further comprising:
 deploying cutting elements radially outwardly away from the central longitudinal axis of the elongated shaft; and 
 moving the cutting elements proximally relative to the capture member to cut tissue. 
 
     
     
       12. The method of  claim 1 , further comprising expanding tensioning arms to extend outwardly away from the elongated shaft, wherein the tensioning arms are radially offset from the capture member to increase radial tension on the blood vessel. 
     
     
       13. The method of  claim 1  wherein:
 intravascularly delivering the distal portion of the elongated shaft to the treatment site within the blood vessel comprises positioning the distal portion in a vein; and 
 the method further comprises cutting fibrous intraluminal tissue with a cutting element deployed form the distal portion of the elongated shaft. 
 
     
     
       14. A method for modifying intraluminal tissue, the method comprising:
 intravascularly delivering a distal portion of an elongated shaft to a treatment site within a blood vessel; 
 deploying capture members at the distal portion of the elongated shaft such that the capture members extend outwardly away from a longitudinal axis of the elongated shaft and place a wall of the blood vessel in tension, wherein each capture member includes a distal joint at its distal terminus, a proximal joint at its proximal terminus, an intermediate joint positioned along its length between the distal and proximal joints, and proximal segment extending between its intermediate joint and its proximal joint; 
 deploying cutting elements at the distal portion of the elongated shaft such that the cutting elements extend outwardly away from the longitudinal axis of the elongated member; and 
 cutting the intraluminal tissue with the cutting elements. 
 
     
     
       15. The method of  claim 14  wherein cutting the intraluminal tissue comprises moving the cutting elements through corresponding elongated openings in the proximal segments to cut the intraluminal tissue. 
     
     
       16. The method of  claim 15  wherein deploying the cutting elements further comprises:
 deploying the cutting elements from a position proximal to the capture members; and 
 moving the cutting element in a distal direction such that the cutting elements move through the corresponding elongated openings. 
 
     
     
       17. The method of  claim 15  wherein deploying the cutting elements further comprises:
 deploying the cutting elements from a position distal to the proximal segments of the capture members; and 
 moving the cutting element in a proximal direction such that the cutting elements move through the corresponding elongated openings. 
 
     
     
       18. The method of  claim 14  wherein the elongated shaft is an outer shaft, and wherein deploying the capture members comprises:
 moving an inner shaft disposed within the outer shaft in a proximal direction relative to the outer shaft, wherein a distal end region of the inner shaft is fixed to a distal end region of the outer shaft such that proximal movement forces each of the capture members away from the outer shaft and each of the proximal segments is concave towards the outer shaft to define a capture region. 
 
     
     
       19. The method of  claim 18  wherein deploying the cutting elements comprises expanding the cutting elements radially outwardly from a cutting shaft slidably disposed within the inner shaft such that the cutting elements extend through corresponding slots in the inner and outer shafts. 
     
     
       20. A method for modifying intraluminal tissue, the method comprising:
 intravascularly delivering a distal portion of an elongated shaft to a treatment site within a blood vessel, the distal portion a capture member; 
 moving the capture member from a low-profile state to a deployed state in which the capture member extends outwardly away from a longitudinal axis of the elongated shaft to place a wall of the blood vessel in tension, wherein the capture member includes a distal joint at its distal terminus, a proximal joint at its proximal terminus, an intermediate joint positioned along its length between the distal and proximal joints, and proximal segment extending between its intermediate joint and its proximal joint; and 
 capturing the intraluminal tissue within a capture region formed by the proximal segment of the capture member; and 
 deploying a cutting element at the distal portion of the elongated shaft such that the cutting element extends outwardly away from the longitudinal axis of the elongated member to cut the intraluminal tissue. 
 
     
     
       21. The method of  claim 20  wherein moving the capture member to the deployed state causes the proximal segment to be concave toward the outer shaft.